Individual
DR. DANIEL SCOTT MULCONREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6000 N ALLEN RD, PEORIA, IL 61614-3294
(309) 691-1400
(309) 689-7081
Mailing address
6000 N ALLEN RD, PEORIA, IL 61614-3294
(309) 691-1400
(309) 689-7081
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
036118429
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036118429
—
IL
Enumeration date
06/26/2006
Last updated
12/27/2024
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